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Individual

JOHN K DERDERIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
555 N DUKE ST, LANCASTER, PA 17602-2250
(717) 544-5511
Mailing address
555 N DUKE ST, LANCASTER, PA 17602-2250

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS011857
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100820028
PA
Enumeration date
06/12/2006
Last updated
11/01/2025
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